Rhinophyma: Symptoms, Causes, and Treatment Options
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is rhinophyma?
Rhinophyma, also called phymatous rosacea, is a skin condition in which the nose gradually becomes large, bumpy and bulb-like due to overgrowth of oil glands and connective tissue. It can be an advanced stage of rosacea but can also occur without it. It is not life-threatening but can block nasal breathing. Treatment removes excess tissue and reshapes the nose. [1]
What the research says
This study found no link between alcohol and rhinophyma. In a Scottish series of 45 rhinophyma patients compared with 48 men having eyelid surgery, alcohol consumption did not differ between the groups (p > 0.20), and no coincidental skin cancers were found at surgery, even though older reports had cited rates of 15 to 30% (Curnier & Choudhary, Plast Reconstr Surg, 2004). [3]
Several treatments give similar results. A systematic review of rhinophyma treatment found that outcomes with carbon dioxide laser, scalpel excision, and electrocautery were equivalent. The subunit method had the highest complication and revision rates, followed by CO2 laser, and over 89% of patients would recommend treatment regardless of the method (Chauhan et al., Clin Cosmet Investig Dermatol, 2020). [2]
What Is Rhinophyma?
Rhinophyma is a skin condition that causes the nose to gradually become large, bumpy, and bulb-like. It usually affects the tip of the nose but can also involve the sides and the skin on top. It takes several years to develop, and if it is not treated the changes may be permanent. [1]
The word “rhinophyma” literally means “nose growth.” Doctors describe four types, based on what drives the overgrowth: [1]
What are the symptoms and early warning signs of rhinophyma?
The shape, look, and color of the nose change gradually. Catching the early signs matters, because early rosacea care may help prevent progression. [1]
Stage | Common Signs |
|---|---|
Early stage | Some skin discoloration, noticeable thickening, small lumps forming, and visibly widened blood vessels under the skin. |
Advanced stage | A bulbous tip that grows in different directions, lumps, swelling, enlarged pores or visible oil glands, and a waxy or rough surface. Color can range from red to purple or darker than your natural skin tone. |
Functional impact | A larger nose tip can block the nasal passage and make breathing out through the nose harder. |
What causes rhinophyma, and what are common misconceptions?
Rhinophyma is caused by an overgrowth of sebaceous glands and the connective tissue beneath them, and doctors do not fully know why this happens. Rosacea may lead to it, but you can have rhinophyma without having rosacea. [1]
The alcohol myth. People once believed that heavy drinking caused rhinophyma. This is not true: it occurs just as often in people who drink alcohol as in people who do not (Cleveland Clinic, 2025), and a controlled comparison found no positive association between alcohol and rhinophyma (Curnier & Choudhary, Plast Reconstr Surg, 2004). [1] [3]
Risk Factors
Possible Complications
Besides breathing difficulty, rhinophyma can affect mental health and self-esteem, and some people feel self-conscious or socially isolated. A skin cancer called basal cell carcinoma can occasionally develop on the nose, and scientists are still working out whether rhinophyma plays a role. [1]
How is rhinophyma diagnosed?
A dermatologist can usually diagnose rhinophyma with an exam and a review of your symptoms and personal and family history, including any history of rosacea. No other testing is usually needed. If symptoms do not improve after treatment, your provider may order a skin biopsy to check for cancer or other conditions. [1]
How is rhinophyma treated and managed?
Rhinophyma tissue does not shrink by itself once thickened, so treatment relies on dermabrasion, laser resurfacing, cryotherapy or surgery rather than medicines alone. Medicines such as the ones used for rosacea can help early symptoms like redness, but medical therapy has not been effective at reversing the disease process, and surgery remains the most accepted treatment (Little et al., Facial Plast Surg, 2012). Your dermatologist may suggest: [4]
Dermabrasion: A rotating device “sands” away skin to reveal smoother skin underneath. [1]
Laser skin resurfacing: Concentrated light removes outer layers of skin and can reduce enlarged blood vessels. [1]
Cryotherapy: Extreme cold freezes and destroys abnormal tissue. [1]
Surgery: Used to reshape the nose, remove excess tissue and oil glands, reduce enlarged blood vessels, and improve breathing. [1]
No single method is considered the gold standard. In a systematic review, scalpel excision was more cost-effective with fewer postoperative complications but carried a risk of poor bleeding control during surgery, and CO2 laser, scalpel, and electrocautery gave equivalent outcomes (Chauhan et al., Clin Cosmet Investig Dermatol, 2020). There is no cure, and symptoms can rarely return, so ask your provider about the risks, benefits, and realistic expectations before you choose. [1] [2] [4]
For the underlying rosacea, treatment can include topical metronidazole or azelaic acid, oral antibiotics, and isotretinoin in severe cases, which can cause severe birth defects and in the U.S. is available only through the iPLEDGE safety program (Sobottka & Lehmann, Hautarzt, 2009). [5]
How can people live with rhinophyma, and can it be prevented?
Treatment is not only about appearance. It can also restore easier breathing and improve confidence. Because rhinophyma is a severe form of rosacea, the best way to lower your risk is to manage rosacea early with a dermatologist. [1]
Treat rosacea early: Follow your treatment plan and ask a dermatologist about options. [1]
Know your triggers: Common rosacea triggers include sun exposure, hot drinks, spicy foods, and stress. Gentle skincare with non-irritating products helps.
Watch your nose: Tell your provider about any skin that looks raised, discolored, thickened, or swollen.
Keep up with follow-up visits: Regular skin checks help track progression and adjust treatment.
Conclusion
Rhinophyma is manageable, but it needs specialist care. Understanding the early signs and letting go of myths about its cause helps people seek treatment sooner. Whether through laser, dermabrasion, or surgical reshaping, modern treatment can improve both the look of the nose and breathing.
What are the next steps if you have rhinophyma?
If your nose is becoming redder, thicker, or lumpier, book an appointment with a dermatologist soon. If you have rosacea, follow your treatment plan closely. If you already have advanced rhinophyma, talk with a dermatologist or surgeon about reshaping and breathing options.
Trusted resources: National Rosacea Society, American Academy of Dermatology.
Frequently Asked Questions
Is rhinophyma a type of cancer?
No. Rhinophyma is a benign skin condition. However, a skin cancer called basal cell carcinoma can sometimes develop on the nose, so a doctor may order a biopsy if symptoms do not improve after treatment or if anything looks unusual. [1]
Can women get rhinophyma?
Yes, but it is more common in men. Being male, having a family history of rosacea or rhinophyma, and having fair skin are the main risk factors. [1]
Does rhinophyma go away on its own?
No. It develops over several years, and if it is not treated the changes may become permanent. Treatment usually involves a procedure to remove excess tissue and reshape the nose. [1]
Is surgery for rhinophyma only cosmetic?
Not always. The goals of surgery include reshaping the nose, removing excess tissue and oil glands, reducing enlarged blood vessels, and improving your ability to breathe. [1]
How long does it take for rhinophyma to develop?
It can take several years for the nose to change shape, usually starting with mild redness and skin thickening. [1]
Can I prevent rhinophyma if I have rosacea?
Managing rosacea early with a dermatologist may prevent rhinophyma. Rosacea can also occur without rhinophyma, and rhinophyma can occur without a rosacea diagnosis. [1]
Will my nose keep changing without treatment?
Rhinophyma is progressive. The tissue can keep thickening over time, and untreated changes may become permanent.
Are there medicines for rhinophyma?
Can rhinophyma come back after treatment?
Rhinophyma coming back after treatment is rare, but symptoms can return. Your dermatologist will take steps to lower that risk, and long-term follow-up is a good idea. [1]
Is rhinophyma contagious?
No. It is a chronic inflammatory skin condition and cannot be spread to other people.
What are the waxy bumps on my nose?
The waxy bumps on the nose are often enlarged sebaceous (oil) glands. A waxy or rough surface texture, enlarged pores, and visible oil glands are typical signs of rhinophyma. [1]
Can laser treatment fix a bulbous nose?
Laser skin resurfacing is one of several treatment options. A systematic review found that carbon dioxide laser, scalpel excision, and electrocautery give equivalent results, so the best choice depends on your dermatologist’s or surgeon’s experience and your goals. [2]
Can rhinophyma affect mental health?
Yes. A visible change to the nose can lead to self-consciousness or social isolation. Treating it is not only about appearance; it can improve breathing and well-being. [1]
Related Reading
Understanding Rosacea: Symptoms, Types, and Management Strategies explains the skin condition that can lead to rhinophyma.
CO2 Laser Resurfacing: What It Treats, How Recovery Works, and the Risks to Know describes a laser treatment used to reshape thickened nose skin.
Dermabrasion: Uses, Procedure, Recovery, Risks and Results explains a skin-sanding procedure sometimes used to treat rhinophyma.
What Is Basal Cell Carcinoma? Symptoms, Causes, and Treatment covers a common skin cancer that can rarely develop within rhinophyma.
References
Cleveland Clinic. Rhinophyma. Cleveland Clinic. June 18, 2025. https://my.clevelandclinic.org/health/diseases/rhinophyma
Chauhan R, Loewenstein SN, Hassanein AH. Rhinophyma: prevalence, severity, impact and management. Clin Cosmet Investig Dermatol. 2020;13:537–551. PMID 32848439. https://doi.org/10.2147/CCID.S201290
Curnier A, Choudhary S. Rhinophyma: dispelling the myths. Plast Reconstr Surg. 2004;114(2):351–354. PMID 15277798. https://doi.org/10.1097/01.prs.0000131875.67987.69
Little SC, Stucker FJ, Compton A, et al. Nuances in the management of rhinophyma. Facial Plast Surg. 2012;28(2):231–237. PMID 22562574. https://doi.org/10.1055/s-0032-1309304
Sobottka A, Lehmann P. Rosacea 2009: new advances in pathophysiology, clinical staging and therapeutic strategies [article in German]. Hautarzt. 2009;60(12):999–1009. PMID 19957073. https://doi.org/10.1007/s00105-009-1825-y
Medical disclaimer
This article is for informational purposes only and does not constitute medical advice. Rhinophyma is a chronic skin condition that requires professional diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.
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